Ultrasound guidance has been suggested as a valuable aid to enhance Fine Needle Aspiration Biopsy (FNAB) performance in the preoperative diagnosis of thyroid nodules. We compared diagnostic accuracy of conventional FNAB (C-FNAB) versus sonography-guided FNAB (SG-FNAB) by reviewing a large sample population of 9,683 patients with thyroid nodules. 4,986 patients were investigated by C-FNAB while 4,697 underwent SG-FNAB. A valuable cytologic diagnosis was obtained in 85.9% of C-FNAB and in 91.5% of SG-FNAB cases, thyroid cancer being detected in 1.6% and 2.1% of patients, respectively. Specimens were inadequate for cytology (8.7%) but only in 167 SG-FNAB cases (3.5%). The indeterminate pattern of follicular neoplasia was equally observed in 238 C-FNAB (5%) and in 272 (5.4%) SG-FNAB nodules. A total of 535 C-FNAB and 540 SG-FNAB patients underwent surgery. False-negative results occurred in 7 (2.3%) C-FNAB but only in 3 (1%) SG-FNAB cases. Sensitivity, specificity and global diagnostic accuracy of C-FNAB as compared to SG-FNAB were 91.8% vs. 97.1%, 68.8% vs. 70.9% and 72.6% vs. 75.9%, respectively. In conclusion, SG-FNAB allows a more precise and adequate sampling of thyroid nodular lesions and is associated to a lower rate of false negative diagnoses thus improving overall diagnostic accuracy in the preoperative selection of thyroid cancer. (Work supported by AIRC and MURST research grants).
ACCURACY OF SONOGRAPHY-GUIDED VERSUS CONVENTIONAL FINE NEEDLE ASPIRATION BIOPSY
1998
Abstract
Ultrasound guidance has been suggested as a valuable aid to enhance Fine Needle Aspiration Biopsy (FNAB) performance in the preoperative diagnosis of thyroid nodules. We compared diagnostic accuracy of conventional FNAB (C-FNAB) versus sonography-guided FNAB (SG-FNAB) by reviewing a large sample population of 9,683 patients with thyroid nodules. 4,986 patients were investigated by C-FNAB while 4,697 underwent SG-FNAB. A valuable cytologic diagnosis was obtained in 85.9% of C-FNAB and in 91.5% of SG-FNAB cases, thyroid cancer being detected in 1.6% and 2.1% of patients, respectively. Specimens were inadequate for cytology (8.7%) but only in 167 SG-FNAB cases (3.5%). The indeterminate pattern of follicular neoplasia was equally observed in 238 C-FNAB (5%) and in 272 (5.4%) SG-FNAB nodules. A total of 535 C-FNAB and 540 SG-FNAB patients underwent surgery. False-negative results occurred in 7 (2.3%) C-FNAB but only in 3 (1%) SG-FNAB cases. Sensitivity, specificity and global diagnostic accuracy of C-FNAB as compared to SG-FNAB were 91.8% vs. 97.1%, 68.8% vs. 70.9% and 72.6% vs. 75.9%, respectively. In conclusion, SG-FNAB allows a more precise and adequate sampling of thyroid nodular lesions and is associated to a lower rate of false negative diagnoses thus improving overall diagnostic accuracy in the preoperative selection of thyroid cancer. (Work supported by AIRC and MURST research grants).I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
